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NPI Code Detail

MEDICARE: SAMANTHA ANN MILLER

MEDICARE: SAMANTHA ANN MILLER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1093466229
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA ANN MILLER
Provider Business Mailing Address
First Line : 5039 VILLA LINDE PKWY STE 30
Second Line :
City : FLINT
State : MI
Zip : 48532-3450
Country : US
Telephone Number : 989-401-2244
Fax Number :
Provider Business Practice Location Address
First Line : 195 HURON BLVD
Second Line :
City : MARYSVILLE
State : MI
Zip : 48040-1421
Country : US
Telephone Number : 810-662-3721
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2022
Last Update Date : 01/10/2022

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Directions to “ SAMANTHA ANN MILLER ” Practice Location

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